Designing evidence‐based treatments for youth with multiple and complex needs: a modular practice elements approach

Young people receiving services for substance use problems often experience high rates of other psychosocial problems in addition to mental disorders. This has implications for design of effective interventions. There is a lack of concisely organised practical information to help organisations serving this population establish contextually relevant and rigorous approaches to the design of evidence‐based interventions. This paper aims to focus on these issues.

Drawing on literature from clinical and implementation science, this paper describes a new approach to the development and implementation of evidence‐based practice (EBP). Contributions of innovators, early adopters, evaluators, and other scholars are reviewed and synthesized.

Traditional approaches to EBP relying on manualised programs targeting discrete diagnoses have not yielded meaningful progress in the dissemination of EBP to services that specialise in treatment and support for young people experiencing complex psychosocial needs. Recent initiatives are moving away from reliance on manualised programs and adopting a modular practice elements approach that enables maximum flexibility in responding to the unique needs of individual clients. This approach has potential to mitigate barriers to implementation of EBP in resource poor environments.

The complexity of needs presented by young people with dual mental health and substance use problems is increasingly recognised, but there is little information available that supports the formulation evidence‐based interventions that directly address this complexity. This paper applies knowledge from research to the practical challenges faced by practice leaders in real‐world services.